Case Control Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Nov 10, 2018; 9(7): 133-139
Published online Nov 10, 2018. doi: 10.5306/wjco.v9.i7.133
Mismatch repair protein expression and intratumoral budding in rectal cancer are associated with an increased pathological complete response to preoperative chemoradiotherapy: A case-control study
Leonardo S Lino-Silva, Armando Gamboa-Domínguez, Diego Zúñiga-Tamayo, Rosa A Salcedo-Hernández, Lucely Cetina, David Cantú-de-León
Leonardo S Lino-Silva, Surgical Pathology, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
Armando Gamboa-Domínguez, Diego Zúñiga-Tamayo, Surgical Pathology, Instituto Nacional de ciencias Médicas y Nutrición salvador Zubirán, Mexico City 14080, Mexico
Rosa A Salcedo-Hernández, David Cantú-de-León, Surgical Oncology, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
Lucely Cetina, Medical Oncology, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
Author contributions: Lino-Silva LS, Gamboa-Domínguez A and Zúñiga-Tamayo D contributed equally to this work; Salcedo-Hernández RA, Cetina L and Cantú-de-León D designed research, Lino-Silva LS, Gamboa-Domínguez A, Zúñiga-Tamayo D and Salcedo-Hernández RA wrote the paper.
Institutional review board statement: This work was authorized by the institutional review board of the National Cancer Institute of Mexico with the number REV/16/87.
Informed consent statement: A waiver form informed consent was provided due the retrospective nature of the study and data were collected from clinical files and pathology database.
Conflict-of-interest statement: The authors declared no potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Leonardo S Lino-Silva, MSc, Academic Research, Doctor, Gastrointestinal Pathology Division, Instituto Nacional de Cancerología de México (Mexico’s National Cancer Institute), Av. San Fernando # 22, Sección XVI, Tlalpan, Mexico City 14080, Mexico. saul.lino.sil@gmail.com
Telephone: +52-55-34265921
Received: July 6, 2018
Peer-review started: July 6, 2018
First decision: August 6, 2018
Revised: August 18, 2018
Accepted: October 24, 2018
Article in press: October 24, 2018
Published online: November 10, 2018
ARTICLE HIGHLIGHTS
Research background

Several histopathological, immunohistochemical, and molecular markers have been analyzed in rectal carcinoma in an attempt to predict the pathological complete response (pCR) to neoadjuvant chemoradiotherapy (nCRT) with contradictory results.

Research motivation

Identifying characteristics of tumors that will respond to nCRT could help avoid surgery.

Research objectives

To determine whether the association of rectal adenocarcinoma with a defective-Mismatch repair system (dMMR) are associated with the rate of pCR. To identify histologic features in the diagnostic biopsy associated with the rate of pCR.

Research methods

A case-control study design paired 2:1 was performed.

Research results

The pCR was associated with well-differentiated tumors, dMMR, the absence of vascular invasion, and low tumor budding in the diagnostic biopsy. In the multivariant analysis, the factors independently associated with the pCR were dMMR and a low degree of tumor budding.

Research conclusions

Tumors with pCR were associated with the dMMR status and low tumor budding in the diagnostic biopsy.

Research perspectives

Adding the status of both MMR and tumor budding to the current and future prognostic indexes could help predict the pCR of a rectal adenocarcinoma and evaluate alternative strategies for the care of these patients.